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乳腺髓系肉瘤作为干细胞移植后急性髓系白血病复发的超声特征:病例报告

Sonographic Features of a Myeloid Sarcoma of the Breast as a Relapse of Acute Myeloid Leukemia After Stem-Cell Transplantation: A Case Report.

作者信息

Kim Suk Jung, Kim Woo Gyeong

机构信息

Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.

Department of Pathology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.

出版信息

Am J Case Rep. 2019 Apr 28;20:612-619. doi: 10.12659/AJCR.915453.

Abstract

BACKGROUND Myeloid sarcoma is a rarely observed extramedullary presentation of myeloid leukemia that seldom manifests in the breast. Myeloid sarcoma can occur before, concurrently with, or following acute myeloid leukemia presentation. Few reports have focused on the imaging findings in cases of myeloid sarcoma of the breast, and the existing findings are variable and nonspecific; the present case report aimed to bridge this gap. CASE REPORT A 24-year-old female presented with a palpable lump at the upper outer quadrant of her right breast. She had noticed the mass 2 days prior to presentation. She was first diagnosed with acute myelogenous leukemia 18 months before the lump presentation and had undergone haploidentical stem cell transplantation 6 months prior. At the time of the breast lump presentation, she was undergoing chemotherapy for relapsed acute myeloid leukemia. Ultrasonography of her right breast revealed a circumscribed, oval mass corresponding to the palpable lump. Ultrasonography-guided 14-gauge core needle biopsy was performed on the breast mass, leading to a pathological diagnosis of myeloid sarcoma. CONCLUSIONS We reported a case of myeloid sarcoma involving the breast. On sonography, although the internal echotexture resembled that of breast hamartoma, the observed hard elasticity and high vascularity raised suspicions of malignancy.

摘要

背景 髓系肉瘤是髓系白血病罕见的髓外表现,很少出现在乳腺。髓系肉瘤可在急性髓系白血病出现之前、同时或之后发生。很少有报告关注乳腺髓系肉瘤的影像学表现,现有的表现多样且不具特异性;本病例报告旨在填补这一空白。病例报告 一名24岁女性因右乳外上象限可触及肿块就诊。她在就诊前两天发现了该肿块。她在肿块出现前18个月首次被诊断为急性髓系白血病,并在肿块出现前6个月接受了单倍体干细胞移植。在出现乳腺肿块时,她正在接受复发急性髓系白血病的化疗。她右乳的超声检查显示一个与可触及肿块相对应的边界清晰的椭圆形肿块。对乳腺肿块进行了超声引导下14号粗针活检,病理诊断为髓系肉瘤。结论 我们报告了一例累及乳腺的髓系肉瘤病例。在超声检查中,尽管内部回声纹理类似于乳腺错构瘤,但观察到的硬弹性和高血管性增加了恶性肿瘤的怀疑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53e8/6501734/45331b6a457c/amjcaserep-20-612-g001.jpg

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